CPEN key terms

An early shock state in which the child maintains normal blood pressure through increased heart rate and vasoconstriction, even though tissue perfusion is inadequate. Hypotension is a late and ominous sign in pediatrics.

The seconds required for color to return to a fingertip or central skin area after brief pressure. Prolonged central refill suggests poor perfusion and is a key pediatric shock indicator.

A rapid, narrow-complex rhythm originating above the ventricles, often 220 beats/min or faster in infants. It causes poor feeding, irritability, and shock and usually requires vagal maneuvers or adenosine.

A sudden worsening of cyanosis and hypoxia in a child with tetralogy of Fallot, often triggered by crying or feeding. Knees-to-chest positioning and oxygen are initial emergency measures.

A heart defect in which survival depends on a patent ductus arteriosus for pulmonary or systemic blood flow. Prostaglandin E1 infusion is used emergently to keep the ductus open.

Inability of the respiratory system to oxygenate or ventilate adequately, producing hypoxemia or hypercapnia. In children, rising respiratory rate, grunting, and exhaustion are warning signs before apnea.

A high-pitched, primarily inspiratory sound caused by turbulent airflow through a narrowed upper airway. It signals obstruction and may worsen quickly in children with croup or an inhaled foreign body.

Visible inward pulling of the chest wall muscles between ribs, below the ribs, or above the sternum during breathing. They indicate increased work of breathing and possible respiratory distress in children.

A severe asthma attack that does not respond to initial bronchodilator therapy. It requires repeated treatment, oxygen, steroids, and close monitoring for silent chest and respiratory failure.

A viral lower respiratory infection, most often caused by respiratory syncytial virus, affecting infants. It produces wheezing, crackles, and increased work of breathing; treatment is mainly supportive.

Laryngotracheobronchitis, a viral upper airway infection in young children causing a barking cough, hoarse voice, and inspiratory stridor. Cool mist and dexamethasone are common treatments.

A standardized score of eye, verbal, and motor responses adapted for infants and children. It quantifies level of consciousness and helps detect neurological deterioration.

A seizure lasting longer than five minutes or repeated seizures without recovery between them. It is a neurological emergency requiring prompt benzodiazepine administration and airway support.

A seizure occurring with fever in a child usually between six months and five years of age, without central nervous system infection. Most are brief and do not require long-term anticonvulsants.

Elevated pressure inside the skull from swelling, bleeding, or fluid. In children it may cause headache, vomiting, altered consciousness, and bradycardia with hypertension.

Infection and inflammation of the membranes surrounding the brain and spinal cord. Bacterial meningitis in children can cause fever, neck stiffness, headache, and rapid deterioration requiring antibiotics.

Telescoping of one segment of bowel into another, usually at the ileocecal valve in infants. It causes colicky pain, vomiting, and currant-jelly stools and may require air enema reduction.

Thickening of the pyloric muscle causing projectile, nonbilious vomiting in infants around two to six weeks of age. It leads to dehydration and hypochloremic metabolic alkalosis.

Green-tinged vomit that indicates bile in the stomach, suggesting obstruction beyond the ampulla of Vater. In a newborn it is a surgical emergency until malrotation with volvulus is excluded.

Inflammation of the appendix, often causing periumbilical pain that migrates to the right lower abdomen, anorexia, and fever. Perforation risk is higher in young children because presentation is atypical.

A deficit of total body water and electrolytes, commonly from vomiting or diarrhea. Pediatric signs include dry mucous membranes, decreased urine output, tachycardia, and sunken eyes.

Twisting of the spermatic cord that cuts off blood flow to the testicle. It causes sudden severe scrotal pain and is a surgical emergency; salvage is best within six hours.

A bacterial infection of the urinary tract that in infants may present only with fever, poor feeding, or vomiting. Urine culture confirms diagnosis and prompt antibiotics prevent kidney damage.

A sudden decline in kidney function causing retention of waste products and reduced urine output. In children it may follow dehydration, sepsis, or nephrotoxic medications.

Increased pressure within a closed muscle compartment that impairs blood flow and can cause tissue death. Severe pain out of proportion, pallor, and paresthesias are warning signs requiring urgent fasciotomy.

A fracture involving the growth plate in children, classified into five types by involvement of the physis, metaphysis, and epiphysis. It requires careful evaluation because growth disturbance can result.

Radial head subluxation caused by a sudden pull on a young child's arm. The child holds the arm still and refuses to use it; reduction is usually achieved by flexion and supination.

A severe immune-mediated skin reaction causing painful blistering and detachment of mucous membranes, often triggered by medications or infections. It is a dermatologic emergency requiring burn-unit-level care.

A method for estimating burn surface area using body regions, adjusted for children because their heads are proportionally larger and legs smaller than adults. Accurate sizing guides fluid resuscitation.

A burn involving the epidermis and part of the dermis, producing blisters, moist tissue, and severe pain. It requires cooling, gentle cleaning, and dressing to prevent infection.

Painful episode in sickle cell disease caused by sickled red blood cells blocking small blood vessels. It requires aggressive hydration, analgesia, oxygen if hypoxic, and evaluation for complications.

Fever in a child with a dangerously low neutrophil count, often after chemotherapy. It is an emergency requiring immediate cultures and broad-spectrum antibiotics because sepsis can progress rapidly.

A metabolic emergency after rapid destruction of cancer cells, causing high potassium, phosphate, and uric acid with low calcium. It can lead to kidney injury and arrhythmias and requires hydration and monitoring.

A complication of diabetes with high blood glucose, ketones, and metabolic acidosis. In children it causes dehydration, vomiting, and Kussmaul breathing and requires careful fluid and insulin therapy.

Abnormally low blood glucose that can cause irritability, sweating, seizures, and coma in children. Immediate glucose administration is required to prevent brain injury.

Acute insufficiency of adrenal hormones causing shock, low blood sugar, and low sodium. Children with congenital adrenal hyperplasia need emergency hydrocortisone during illness or injury.

Physical, sexual, emotional abuse or neglect of a child. Emergency nurses must recognize suspicious injuries, document objectively, and follow mandatory reporting laws.

A brief, structured assessment asking an adolescent about thoughts of self-harm, plan, and intent. Positive screens require immediate safety measures and mental health evaluation.

An approach that recognizes the impact of past trauma and avoids re-traumatization through safety, trust, choice, and collaboration. It is especially important during emergency procedures with children.